<div class="row">
    <div class="col-xs-12">
        <div class="panel panel-midnightblue">
            <div class="panel-body">
				<form action="" class="form-horizontal row-fluid"  data-validate="parsley" id="validate-form">
					<div class="row">
						<div class="col-sm-9">
							<div class="row">
							<div class="col-sm-12">
								<div class="form-group">
									<label class="col-sm-2 control-label has-error" for="order_id">购柜会员信息:</label>
									<div class="col-sm-8">
										<select name="order_id" id="order_id"  style="width: 100%;" required></select>
									</div>
								</div>
							</div>

							<div class="col-sm-6">
								<div class="form-group">
									<label class="col-sm-4 control-label">会员姓名:</label>
									<div class="col-sm-8">
										<input type="text" id="member_name" class="form-control" readonly>
									</div>
								</div>
							</div>
							<div class="col-sm-6">
								<div class="form-group">
									<label class="col-sm-4 control-label" >会员手机号:</label>
									<div class="col-sm-8">
										<input type="text" id="mobile" class="form-control" readonly>
									</div>
								</div>
							</div>
							<div class="col-sm-6">
								<div class="form-group">
									<label class="col-sm-4 control-label" >卡种名称:</label>
									<div class="col-sm-8">
										<input type="text" id="gym_card_name" class="form-control" readonly>
									</div>
								</div>
							</div>
								<div class="col-sm-6">
									<div class="form-group">
										<label class="col-sm-4 control-label" >会员性别:</label>
										<div class="col-sm-8">
											<input type="text" id="member_sex" class="form-control" readonly>
										</div>
									</div>
								</div>
							</div>
							<div class="row">
								<div class="col-sm-6">
									<div class="form-group">
										<label class="col-sm-4 control-label has-error" >租柜区域:</label>
										<div class="col-sm-8">
											<select class="form-control" name="region_id" id="region_id" style="width: 100%;" required>
												<option value="">选择区域</option>
												{foreach name="regions" item="v" key="k"}
												<option value="{$k}">{$v}</option>
												{/foreach}
											</select>
										</div>
									</div>
								</div>
								<div class="col-sm-6">
									<div class="form-group">
										<label class="col-sm-4 control-label" >租柜编号:</label>
										<div class="col-sm-8">
											<select class="form-control" name="cabinet_id" id="cabinet_id" style="width: 100%;" required>
											</select>
										</div>
									</div>
								</div>
								<div class="col-sm-12">
									<div class="form-group">
										<label class="col-sm-2 control-label has-error" >租期:</label>
										<div class="col-sm-4">
											<div class="input-group">
												<input type="text" id="duration" name="duration" class="form-control" placeholder="大于0的整数" required>
												<div class="input-group-addon">月</div>
											</div>

										</div>
									</div>
								</div>
								<div class="col-sm-6">
									<div class="form-group">
										<label class="col-sm-4 control-label" >租柜开始日期:</label>
										<div class="col-sm-8">
											<input type="text" id="start_date" class="form-control" name="start_date" placeholder="开始日期" value="{php}echo date('Y-m-d'){/php}" required>
										</div>
									</div>
								</div>
								<div class="col-sm-6">
									<div class="form-group">
										<label class="col-sm-4 control-label" >到:</label>
										<div class="col-sm-8">
											<input type="text" id="end_date" class="form-control" placeholder="结束日期" readonly>
										</div>
									</div>
								</div>
								<div class="col-sm-12">
									<div class="form-group">
										<label class="col-sm-2 control-label" >签约日期:</label>
										<div class="col-sm-4">
											<input type="text"  value="{php}echo date('Y-m-d'){/php}"  id="order_date" name="order_date" class="form-control datepicker" required/>
										</div>
									</div>
								</div>
							<div class="col-sm-12">
								<div class="form-group">
									<label class="col-sm-2 control-label" >合同金额:</label>
									<div class="col-sm-4">
										<input type="text" id="money" name="money" class="form-control" placeholder="元" required>
									</div>
								</div>
							</div>
							<div class="col-sm-12">
								<div class="form-group">
									<label class="col-sm-2 control-label" >销售人员:</label>
									<div class="col-sm-4">
										<select class="employee_id"  name="employee_id"  id="employee_id" style="width: 100%;" required>
											<option value="">请选择销售人员</option>
										</select>
									</div>
								</div>
							</div>
						</div>
						</div>
						<div class="col-md-3 col-sm-3">
							<img data-src="holder.js/140x140" id="face1" class="img-rounded" alt="140x140" style="width: 140px; height: 140px;" src="" data-holder-rendered="true">
						</div>
					</div>
					<input type="hidden" id="price" value="">
				</form>
                </div>
                
                <div class="panel-footer">
	                <div class="row">
	                    <div class="col-sm-6 col-sm-offset-4">
	                        <div class="btn-toolbar">
	                            <div class="row">
			                		 <div class="form-group">
			                    		<div class="col-sm-3">
			                    			 <div class="btn-primary btn" id="form-submit">确定</div>
			                    		</div>
			                    		<div class="col-sm-3">
			                    			 <div class="btn-default btn" data-dismiss="modal">关闭</div>
			                    		</div>
			                   		 </div>
	                			</div>
	                        </div>
	                    </div>
	                </div>
            	</div>
                
            </div>
        </div>
    </div>
</div>
<script type='text/javascript' src='{$Think.GYM_VIEW_JS}cabinet/orderAdd.js'></script>